Understanding Trust

Trust is the foundation of effective relationships between communities, clinicians, researchers, policymakers and institutions. It enables collaboration, supports scientific progress and ensures that health interventions are understood, accepted and applied equitably.

When trust is strong, it helps translate evidence into action, promotes community participation in research and enhances the legitimacy of public health advice. When trust is weak or eroded, it can lead to disengagement, reduced uptake of evidence-based care and vulnerability to misinformation.

The Academy’s analysis identifies that most Australians trust doctors and scientists, but this trust is fragile and uneven across contexts.

Key findings include:

• 77% of Australians report trust in scientists, yet 61% worry that medical science may be politicised.
• Early childhood vaccination coverage at two years of age has fallen below 90% for the first time since 2016.
• 66% of Australians trust doctors, the highest of any profession, yet behavioural data show persistent declines in vaccine uptake and engagement with public health programs.
• Trust in institutions overall has dropped to 49%, with lower levels of trust reported in government and media compared with healthcare and science.

Trust in HMS refers to confidence in, and willingness to rely on, the people, processes, institutions and evidence that make up the health and medical sciences ecosystem.

It is:

• Dynamic: shaped by context, experience and time.
• Relational: built through interactions between patients, clinicians, researchers, policymakers and communities.
• Multidimensional: encompassing trust in evidence, research integrity, governance, communication and equity.

Trust in HMS can flow in multiple directions, from the public to institutions, between professionals within the system, and from institutions to the communities they serve.

The explainer identifies several interconnected dimensions that shape trust across the health and medical sciences system:

1. Contextual and multidirectional relationships: When these elements function well together, they reinforce confidence and collaboration across the sector.
2. Who is placing trust: Different groups, including consumers, clinicians, policymakers and underrepresented communities, experience and express trust differently.
3. What trust is placed in: Confidence in evidence-based healthcare, research integrity, institutions, communication, policy processes, and equity all contribute to trust in HMS.

Global and national data show that Australia’s trust landscape mirrors wider international trends:

• Institutional trust has declined, with Australians ranking 18^th out of 28 countries on the 2025 Edelman Trust Barometer.
• Trust in science remains comparatively high, but varies depending on discipline and perceived relevance.
• Public confidence is highest in doctors, hospitals and universities, and lowest in political leaders and media.
• Misinformation and disinformation have emerged as major threats, with nearly half of young Australians reporting they have made a health decision based on inaccurate content online.

Trust is not distributed evenly across communities. Factors such as age, education, health literacy, socioeconomic status and lived experience shape how individuals perceive health and scientific institutions. For some groups, including Aboriginal and/or Torres Strait Islander peoples and culturally and linguistically diverse communities, historical and structural inequities have contributed to lower levels of trust.

Our Explainer identifies several broad categories that influence trust in health and medical sciences:

1. Institutional factors : Trust is reinforced when institutions demonstrate integrity, transparency, ethical conduct and alignment with public benefit. Research shows that public confidence increases when science is well regulated, peer-reviewed, and clearly communicated.
2. Communication and information ecosystems: Clear, accessible and culturally relevant communication fosters trust. In contrast, misinformation, political framing of science, and inconsistent public messaging can erode confidence. Digital and social media now shape much of the public’s engagement with health information, highlighting the need for authoritative, evidence-based communication.
3. Situational and crisis contexts: Moments of uncertainty, such as pandemics or environmental disasters, place trust under strain. Consistency, transparency, and equitable policy responses are essential to maintaining trust during crises.
4. Individual and demographic factors: Trust is influenced by personal experience, cultural background, and perceptions of fairness or exclusion. Lower income, social marginalisation and poor representation in decision-making correlate with lower levels of institutional trust.

When trust weakens, the effects extend beyond individual behaviour. Reduced trust can lead to:

• Lower participation in health research and clinical trials.
• Resistance to public health measures.
• Reduced compliance with evidence-based medical advice.
• Increased exposure to misinformation and conspiracy narratives.
• Declining confidence in scientific institutions and government decision-making.

Conversely, when trust is strong, health systems are more responsive, policies are better informed, and communities are more resilient to misinformation and health crises.